Mallige Medical Centre Private Limited, Bangalore, Karnataka, India.
BGS Global Institute of Medical Science, Bangalore, Karnataka, India.
Indian J Pathol Microbiol. 2022 Oct-Dec;65(4):886-890. doi: 10.4103/ijpm.ijpm_203_21.
As we approach the aftermath of a global pandemic caused by Severe Acute Respiratory Syndrome-Corona Virus (SARS-CoV-2), the importance of quickly developing rapid screening tests has become very clear from the point of view of containment and also saving lives. Here, we present an explorative study to develop a telepathology-based screening tool using peripheral blood smears (PBS) to identify Coronavirus Disease (COVID-19)-positive cases from a group of 138 patients with flu-like symptoms, consisting of 82 positive and 56 negative samples. Stained blood smear slides were imaged using an automated slide scanner (AI 100) and the images uploaded to the cloud were analyzed by a pathologist to generate semi-quantitative leukocyte morphology-related data. These telepathology data were compared with the data generated from manual microscopy of the same set of smear slides and also the same pathologist. Besides good correlation between the data from telepathology and manual microscopy, we were able to achieve a sensitivity and specificity of 0.83 and 0.71, respectively, for identifying positive and negative COVID-19 cases using a six-parameter combination associated with leukocyte morphology. The morphological features included plasmacytoid cells, neutrophil dysplastic promyelocyte, neutrophil blast-like cells, apoptotic cells, smudged neutrophil, and neutrophil-to-immature granulocyte ratio. Although Polymerase Chain Reaction (PCR) and antibody tests have a superior performance, the PBS-based telepathology tool presented here has the potential to be an interim screening tool in resource-limited settings in underdeveloped and developing countries.
随着由严重急性呼吸系统综合症冠状病毒 2 型（SARS-CoV-2）引发的全球大流行病的余波临近，从控制疫情和拯救生命的角度来看，快速开发快速筛查测试的重要性变得非常明显。在这里，我们进行了一项探索性研究，旨在开发一种基于远程病理学的筛查工具，使用外周血涂片（PBS）从一组 138 例具有流感样症状的患者中识别冠状病毒病（COVID-19）阳性病例，这些患者包括 82 例阳性和 56 例阴性样本。使用自动化玻片扫描仪（AI 100）对染色的血涂片进行成像，并将上传到云端的图像由病理学家进行分析，以生成与白细胞形态相关的半定量数据。将这些远程病理学数据与同一组涂片的手动显微镜生成的数据以及同一位病理学家进行比较。除了远程病理学和手动显微镜数据之间的良好相关性外，我们还能够使用与白细胞形态相关的六个参数组合，分别实现 0.83 和 0.71 的灵敏度和特异性，以识别 COVID-19 阳性和阴性病例。形态特征包括浆细胞样细胞、中性粒细胞发育不良早幼粒细胞、中性粒细胞样细胞、凋亡细胞、模糊中性粒细胞和中性粒细胞至未成熟粒细胞比值。虽然聚合酶链反应（PCR）和抗体测试具有更高的性能，但这里提出的基于 PBS 的远程病理学工具有可能成为资源有限的欠发达和发展中国家的临时筛查工具。
